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Progestogen-only pill

The progestogen-only pill (sometimes called ‘the ‘mini-pill’ or the POP) is a type of female contraception that prevents pregnancy. The main ingredient in it, progestogen, is a hormone similar to that produced in women’s ovaries.

Here are some key facts:

  • It is over 99% effective if taken correctly
  • There are two different types and many different brands
  • You take the POP pill at the same time every day, with no break between packs
  • When taking the POP pill your periods may become lighter, irregular, or they may stop altogether
  • Vomiting, diarrhoea and other medications can affect how the POP works
  • It doesn't protect against sexually transmitted infections (STIs) so you'll also need to use a condom
  • There is an alternative pill called the combined pill (sometimes just called ‘the pill’) which contains both progestogen and oestrogen

How does the POP pill work?

Pregnancy happens when sperm reaches an egg and fertilises it. The POP pill works in two ways to interrupt this process:

  • It mainly works by thickening the mucus from your cervix, making it difficult for sperm to move through and reach an egg
  • It sometimes stops your ovaries releasing an egg (ovulation). This is the main action of POPs containing the hormone desogestrel

If taken correctly, the POP pill is over 99% effective at preventing pregnancy. This means that less than one woman in 100 will get pregnant in a year.

 

How do I get the POP pill?

The POP pill is available free of charge from a range or services including contraceptive clinics, your GP and Brook. Find your nearest one using our find a service tool.

When you go to get the POP pill, an appointment will typically include:

  • A few questions about your medical and family history, to work out what would suit you best.
  • You'll discuss other medicines you are taking in case they can make the POP pill less effective.
  • The doctor or nurse will take your blood pressure and weigh you.

You will not be required to have an internal or breast examination for the POP pill.

When you first start the POP pill you will usually be given a three month supply. Follow up appointments and reviews are then usually every 6-12 months providing there are no issues. You can return to the clinic at any time if you are worried about anything.

Contraception and sexual health services such as Brook are free and confidential, including for people under the age of 16. Health professionals work to strict guidelines and won’t tell anyone else about your visit unless they believe you're at serious risk of immediate harm. Find out more about Brook’s confidentiality policy.

Types of POP pill and how you take them

You take one pill every day from your pack. Depending on the type of pill you are taking this will need to be within either three or 12 hours of the same time each day. With the POP pill you don’t have a break between packs (as with some types of the combined pill), and when you have finished the pack, you start taking the next pack the next day.

There are two different types of progestogen-only pill:

The three-hour POP pill containing the progestogen hormone levonorgestrel or norethisterone. These must be taken within three hours of the same time each day. It is this type that is referred to as the ‘mini pill’. Examples are Femulen, Micronor, Norgeston and Noriday.

The 12-hour POP pill which contains desogestrel (such as Cerazette). This must be taken within 12 hours of the same time each day.

Please note, the pills prescribed by your doctor or nurse may vary. Whatever type of pill you are taking, follow the instructions that come with the packet, paying careful attention to which medicines and antibiotics might affect it. 

Advantages of the POP pill

  • It doesn’t interrupt sex
  • There is no evidence that it causes additional weight gain
  • There are no long term effects to your fertility
  • It can be taken by some women who cannot use the contraception that contains oestrogen, such as the combined pill, contraceptive patch or the vaginal ring
  • It can help with painful periods and premenstrual symptoms.

Disadvantages of the POP pill

Any medication can have some side-effects or disadvantages but for most women the benefits will outweigh the possible risks. Things to watch out for include:

  • Your periods may become irregular. They may happen more often, less often, be lighter or stop altogether. You may also get spotting in between periods. This isn’t harmful and may settle down. If you have concerns seek advice
  • It doesn’t protect against STIs, so you will need to use a barrier method such as condoms
  • You have to take the POP pill around the same time every day (within three hours for some POP pills, and 12 for those containing desogestrel)
  • Some medicines and certain types of antibiotic can make the POP pill less effective
  • You may get some side effects when you first start taking the POP pill, such as spots, headaches, weight change and breast tenderness. These should stop within a few months.

Starting the POP pill and when you are protected from pregnancy

You take one pill every single day with no break. When you first take the pill, choose the time of day that suits you best. Then take it at the same time every day until you finish the packet. You then start the next packet straight away.

If you start taking the POP between day one and day five (inclusive) of your period, you will be protected against pregnancy straight away. 

If you have a short menstrual cycle, where your period normally comes every 23 days or less, starting the POP pill on the fifth day of your period may mean you are not immediately protected (because you might ovulate early in your menstrual cycle).

If you think this might be the case, speak with a doctor or nurse about whether you need to use additional contraception, such as condoms, for the first two days.

If you start taking the pill at any other time in your menstrual cycle, it will take two days before it starts to work. So you'll need to use condoms for the first two days. 

Missed pill information

If you are more than three or 12 hours late if you are taking POPs containing the hormone desogestrel:

  • Take a pill as soon as you remember. If you have missed more than one, only take one
  • Take your next pill at the usual time. This may mean taking two pills in one day. This is not harmful
  • You are not protected against pregnancy. Continue to take your pills as usual, but use an additional method of contraception, such as condoms, for the next two days.

If you are less than three or 12 hours late if you are taking POPs containing the hormone desogestrel:

  • Take a pill as soon as you remember, and take the next one at the usual time, even if this means taking two pills in the same day. You are protected from pregnancy.

What can make the POP pill less effective?

  • Taking it more than three hours late (or 12 hours if you're taking a POP pill containing the hormone Desogestrel)
  • Vomiting within two hours of taking it
  • Very severe diarrhoea lasting more than 24 hours
  • Some medicines can reduce the effectiveness of the pill, such as those used to treat epilepsy, HIV and TB and the complementary medicine St John's Wort.
  • Commonly used antibiotics do not reduce the effectiveness of the pill, but it is always best to check with the doctor, nurse or pharmacist first

If you are given medication by a doctor or a nurse always say that you are taking the POP. Sometimes different medication can interact.

How will it affect my periods?

Your periods may become irregular - they may happen more often, less often, be lighter or stop altogether.

You may also get spotting in between periods. This isn’t harmful and may settle down. If you have concerns speak to a doctor or nurse.

The POP pill can also help with painful periods and premenstrual symptoms.

Coming off the pill

There’s lots of reasons why you might want to stop taking the contraceptive pill. Whatever the reason, here's what happens when you stop taking the pill. 

How quickly it leaves your system: the hormones from the pill will usually leave your body within a couple of days - no matter how long you have been taking the pill for.

How quickly you can get pregnant: this will vary, and will depend on when ovulation (releasing an egg) starts up again. For some people, it may be a matter of days or weeks, for others it may take up to three months. But generally speaking, fertility levels should return quite rapidly, so use condoms or another method if you don’t want to get pregnant.

What happens to your periods: if you find you have irregular periods after stopping taking the pill and are worried, or if it's taking a long time for your periods to start again, you can ask your doctor or nurse for advice.

What physical changes there might be: everyone reacts slightly differently to coming off the pill. For example, some people are prescribed the pill in order to control acne, so stopping taking the pill may cause skin problems to become more severe, although as your hormone levels self-regulate over the course of a few weeks or months, symptoms may subside once again. If symptoms persist or worsen please see a doctor or nurse for help and advice. 

If you stop taking the pill but don't want to become pregnant remember to use another method of contraception. Condoms will also protect against STIs.

Taking the POP pill after having a baby

You can start taking the POP pill any time after the birth. If you start after day 21 you will need to use condoms for two days. The POP pill does not affect the way your breastmilk is produced and you can breastfeed whilst taking the POP pill. A very small amount of hormone enters your breast milk, but research has shown this will not harm your baby.

Taking the POP pill after having an abortion or miscarriage

You can start taking the POP immediately after a miscarriage or abortion and you will be protected from pregnancy immediately. If you start the pill more than five days after the miscarriage or abortion, you'll need to use a barrier method of contraception, such as condoms until you have taken the POP pill for two days.

Last review: August 2017
Next review: August 2019